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War has always been a dangerous business, bringing injury, wounds, and death, and — until recently — often disease. What has changed over time, most dramatically in the last 150 or so years, is the care these casualties receive and who provides it. Medical services have become highly organized and are state sponsored. Diseases are now prevented through vaccination and good sanitation. Sedation now ameliorates pain, and antibiotics combat infection. Wounds that once meant amputation or death no longer do so. Transfers from the field to more-capable hospitals are now as swift as aircraft can make them. The mental consequences of war are now seen as genuine illnesses and treated accordingly, rather than punished to the extreme. Likewise, treatment of those disabled by war and of veterans generally has changed markedly — along with who supplies these and other benefits. This book looks at the history of how humanity has cared for its war casualties, from ancient times through the aftermath of World War II. For each historical period, the author examines the care the sick and wounded received in the field and in hospitals, the care given to the disabled veteran and his dependents, and who provided that care and how. He shows how the lessons of history have informed the American experience over time. Finally, the author sums up this history thematically, focusing on changes in the nature and treatment of injuries, organization of services on and off the battlefield, the role of the state in providing care, and the invisible wounds of war.

Table of Contents

Chapter One

Introduction: Looking to the Past for Lessons . . . to Apply in the Future

Chapter Two

Evolution of the European System of Providing for Casualties: Greece, Rome, the Middle Ages, and the Renaissance

Chapter Three

Evolution of the European System of Providing for Casualties in the Age of Enlightenment: France and Britain as the Antecedents of the American System of Care

Summary: What Happened? — What Have We Learned? — How Did We Get Here?

Appendix

Military Personnel and Casualties from Principal U.S. Wars

Book Review Excerpts

"This comprehensive and well-written volume chronicles military medicine throughout history as the context for a thorough discussion of the American experience in providing care from the battlefield to rehabilitation. Highly recommended for the serious student and the casual reader interested in military medicine!"

- Ronald R. Blanck, Former Surgeon General of the Army

"So often it's remarked that we fail to learn from history — but too frequently there's no good history book from which to learn. One of the several issues where that challenge arises is how we treat those who fall in battle. Bernard Rostker corrects this with his Providing for the Casualties of War. It reminds us that there are few truly new problems — and it instructs us on the successes and failures of the solutions tried before. I would have valued being able to turn to it in the days after 9/11, and I am confident that all those now responsible for these matters will want to read it carefully. Rostker has performed a true public service."

- David Chu, Former Under Secretary of Defense for Personnel and Readiness

"Veterans' benefits compose one of the most important, expensive, and least understood parts of the American welfare state. Unlike other Western nations, the United States runs a separate medical system for its wounded warriors. By excavating the origins and telling the story of the development of medical care for veterans through World War II with deep research and remarkable clarity, Bernard Rostker has performed an invaluable service not only for the military but, as well, for all students of the history of American social policy."

"Bernard Rostker has achieved a masterly combination of both historical breadth and scholarly depth in this much needed history of combat medicine, no easy task. This first volume, of a projected two volume study, frames the dilemma of a military unprepared for war as it confronts the inadequate casualty treatment aspects of warfare. This excellent work is enhanced by numerous charts, graphs, tables, and photographs."

- James Banks, Director, Crile Archives Center for History Education, Western Campus Cuyahoga Community College

Research conducted by

The research described in this report was prepared for the Office of the Secretary of Defense (OSD). The research was conducted within the RAND National Defense Research Institute, a federally funded research and development center sponsored by OSD, the Joint Staff, the Unified Combatant Commands, the Navy, the Marine Corps, the defense agencies, and the defense Intelligence Community.

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Rostker, Bernard, Providing for the Casualties of War: The American Experience Through World War II. Santa Monica, CA: RAND Corporation, 2013. https://www.rand.org/pubs/monographs/MG1164.html. Also available in print form.

Rostker, Bernard,
Providing for the Casualties of War: The American Experience Through World War II, Santa Monica, Calif.: RAND Corporation, MG-1164-OSD, 2013. As of August 14, 2018: https://www.rand.org/pubs/monographs/MG1164.html